Salvia miltiorrhiza

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The root of Salvia miltiorrhiza Bunge (Labiatae) is red in color and was therefore used in TEM to treat related disorders of blood stasis with an action of quickening the blood and dispelling stasis. S. miltiorrhiza and its active ingredients, tan-shinones and salvianolic acids, have anticoagulant, vasodilatory, anti-inflammatory, free-radical scavenging, mitochondrial protective, and other activities. Experimental studies have shown that S. miltiorrhiza dilated coronary arteries and scavenged free radicals in ischemic diseases. Clinical trials also indicated that S. miltiorrhiza was an effective medicine for angina pectoris, myocardial infarction, and stroke [26].

Several studies have investigated possible mechanisms for the protective effect of S. miltiorrhiza against cerebral ischemia. S. miltiorrhiza attenuated dysfunction of VIP [27] and modified ischemic cell changes by modulating somatostatin [28] in cerebral ischemia. S. miltiorrhiza also decreased the size of the infarcted area after CCA ligation in gerbils by inhibiting presynaptic glutamate release and stimulating GABA release [29]. Inhibition of nitric oxide (NO) formation could explain the CNS protective effects observed with S. miltiorrhiza [30].

S. miltiorrhiza may offer an additional therapeutic approach to the management of stroke and ischemia. S. miltiorrhiza has been shown to offer protection against brain ischemia by reducing lipid peroxidation [31]. Pretreatment with S. miltiorrhiza reduced the infarct size in tMCAo-injured SD rats [32]. Tanshinones (Fig. 16.1) are the major lipid-soluble pharmacological constituents of S. miltiorrhiza. Brain infarct volume was reduced following treatment with tanshinone IIa and tanshinone IIb in MCAo mice [33,34].

The therapeutic effect of S. miltiorrhiza may be partly due to its free-radical-scavenging activities, Tanshinones or other structurally related compounds may have potential for further development as neuroprotective drugs. However, systematic review on randomized control trials comparing S. miltiorrhiza with other medicines does not support the notion that S. miltiorrhiza may be beneficial to disability improvement after acute ischemic stroke [35].

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